Osteoporosis Prescreening Risk Assessment (OPERA) Tool

 

Patient selection: postmenopausal woman

 

Parameters:

(1) age in years

(2) body weight in kilograms

(3) history of fracture with minimal trauma after age 45

(4) menopause before the age of 45 years (early menopause)

(5) steroid use

Parameter	Finding	Point
age in years	< 65 years of age	0
	>= 65 years of age	1
body weight in kilograms	>= 57 kilograms	0
	< 57 kilograms	1
number of fractures with minimal trauma after age 45	0	0
	>= 1	1
age at onset of menopause	>= 45 years	0
	< 45 years	1
steroid use	none	0
	<= 5 mg per day or for <= 6 months	0
	> 5 mg per day for > 6 months	1

 

total score =

= SUM(points for all 5 parameters)

 

Interpretation:

• minimum score: 0

• maximum score: 5

• A woman with a score >= 2 should be screened for osteoporosis.

 

Performance:

• The score had a sensitivity of 88% and specificity of 61% at the femoral neck.

• The score had a sensitivity of 90% and specificity of 64% at the lumbar spine.

• The negative predictive value is 96% for the lumbar spine or femoral neck.

• The positive predictive value is 29% in the femoral neck and 39% in lumbar spine.

• The area under the ROC curve is 0.87 for the lumbar spine and 0.81 for the femoral neck.